Individual provider Active NPI

Tayler Benni Resnick, MA, SLP

  • Speech-Language Pathologist
  • Flushing, NY
National Provider Identifier
1508416769
Registry record updated Sep 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
029112 Issued in NY
Practice address
14461 Roosevelt Ave
Flushing, NY 11354-6252
Phone
(718) 939-8700
NPI assigned
Sep 18, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 029112 NY Primary

Addresses

Primary practice location

14461 Roosevelt Ave
Flushing, NY 11354-6252

Mailing address

180 Arlington St
Mineola, NY 11501-2006
Phone (516) 734-1544

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
The Shield of David, Inc. CurrentSince Sep 25, 2019 Accepting new patients

Locations

14461 Roosevelt Ave
Flushing, NY 11354
Phone (718) 886-1534

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1568764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568764800000",
    "number": "1508416769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 ARLINGTON ST",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115012006",
            "telephone_number": "516-734-1544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14461 ROOSEVELT AVE",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113546252",
            "telephone_number": "718-939-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RESNICK",
        "first_name": "TAYLER",
        "middle_name": "BENNI",
        "credential": "MA, SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-18",
        "last_updated": "2019-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "029112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.